Risk factors for postoperative gastrointestinal dysfunction in adult patients undergoing short laparoscopic surgery: a prospective exploratory observational study

Although postoperative gastrointestinal dysfunction (POGD) is common after abdominal surgery, most evidence comes from major procedures, leaving its risk factors after short laparoscopic surgery poorly understood. This study aimed to explore the risk factors for POGD in this surgical context primarily and to examine modifiable strategies for enhancing gastrointestinal recovery secondarily. In this prospective exploratory cohort study, 176 adults undergoing short laparoscopic surgery were included. Multivariable logistic regression was used to identify factors independently associated with POGD. Cox proportional hazards models were employed to assess the relationships between perioperative variables and the time to first flatus. Prolonged operating time (aOR = 1.294 per 10 min, 95% CI: 1.089–1.537, p = 0.003) and longer preoperative fasting for clear liquids (aOR = 1.192 per hour, 95% CI: 1.057–1.345, p = 0.004) were factors independently associated with POGD. Secondarily, in those patients undergoing short laparoscopic surgery, a higher step count on postoperative day 1 (aHR = 1.032 per 100 steps, 95% CI: 1.014–1.051, p = 0.001) and earlier postoperative feeding (aHR = 0.968 per hour, 95% CI: 0.939–0.999, p = 0.043) were significantly correlated with earlier time to flatus. In patients undergoing short laparoscopic surgery, prolonged operating time and extended preoperative fluid fasting are modifiable risk factors for POGD. Earlier postoperative feeding and ambulation were associated with faster gastrointestinal recovery. These findings identify actionable perioperative targets for reducing POGD and enhancing recovery in this setting. ChiCTR2400094411 (Registration Date: 2024-12-23)